Get the free PATIENT EVACUATION TRACKING FORM - OSF HealthCare

HIS 260 PATIENT EVACUATION TRACKING FORM 1. Date 19DEC20192. From (Unit) ICU3. Patient Name Stanley W. Blue4. DOB 11March19696. Diagnosis Epidural Bleed7. Admitting Physician Dr. Rocketscientist8.

How to fill out patient evacuation tracking form

How to fill out patient evacuation tracking form

1. Start by gathering all the necessary information about the patient, such as their name, age, gender, and medical condition.
2. Fill out the patient evacuation tracking form with the patient's personal information, including their contact details and any emergency contact information.
3. Include relevant medical information, such as pre-existing conditions, allergies, and current medications.
4. Document the date and time of the evacuation and the departing location.
5. Provide details about the destination, including the name and address of the receiving facility.
6. Note any special instructions or equipment required for the patient during transportation.
7. Make sure to indicate the mode of transportation used for the evacuation, whether it's an ambulance, helicopter, or other means.
8. Include the names and contact information of any healthcare professionals involved in the evacuation process.
9. Finally, review the completed form for accuracy and ensure all necessary signatures are obtained.

Who needs patient evacuation tracking form?

1. The patient evacuation tracking form is needed by medical professionals, emergency responders, and healthcare facilities who are involved in coordinating and executing patient evacuations.
2. It is particularly important during natural disasters, mass casualty incidents, or when a patient requires transfer between healthcare facilities.
3. This form ensures that all relevant information is documented and allows for effective communication and coordination among the parties involved in the evacuation process.

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